Author Question: A patient is admitted to the hospital after several days of vomiting and diarrhea. After an ... (Read 26438 times)

torybrooks · **on:** Jul 23, 2018

A patient is admitted to the hospital after several days of vomiting and diarrhea.

After an initial bolus of isotonic (0.9) sodium chloride solution, the prescriber orders dextrose 5 in normal saline (D5NS) with 20 mEq potassium chloride to infuse at a maintenance rate. What should the nurse review before implementing this order? (Select all that apply.)
a. Electrocardiogram
b. Arterial blood gas levels
c. Serum electrolyte levels
d. Serum glucose level
e. Urine output

Question 2

A patient arrives in the emergency department complaining of muscle weakness and drowsiness.

The nurse notes a heart rate of 80 beats per minute, a respiratory rate of 18 breaths per minute, and a blood pressure of 90/50 mm Hg. The electrocardiogram reveals an abnormal rhythm. The nurse will question the patient about which over-the-counter medication?
a. Antacids
b. Aspirin
c. Laxatives
d. Potassium supplements

irishcancer18 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A, C, E
Patients receiving potassium should be monitored for cardiovascular toxicity; an ECG before and during administration can help monitor for this adverse effect. Serum electrolyte levels should be reviewed to make sure the patient is not already hyperkalemic. Because potassium is excreted via the kidneys, it is important to determine that renal function is intact. Intravenous potassium should never be given if the patient has not voided. Patients who are hyperkalemic can be treated with sodium bicarbonate to increase pH and insulin to promote uptake of potassium by cells, but it is not necessary to evaluate the blood gas or glucose levels before administering potassium.

Answer to Question 2

ANS: A
Hypermagnesemia can occur when patients are taking magnesium-containing antacids. Symptoms include muscle weakness, sedation, hypotension, and ECG changes. Aspirin would cause metabolic acidosis. Laxatives can contribute to hypokalemia. Potassium supplements would cause hyperkalemia.